The Division of Neonatal and Developmental Medicine at Stanford submits a competing renewal application to participate in the NICHD Cooperative Multicenter Neonatal Research Network (NRN). The Division and its faculty have a history of innovative basic and clinical research accomplishments in neonatal medicine. This expertise dovetails with the Network's goal of rigorous evaluation of treatment and management strategies through multicenter observational studies and interventional trials. Participating in th NRN since 1991, Stanford has proven to be a strong and highly productive asset, contributing extensively to study design, protocol development, execution, analysis, and dissemination of results. Specific strengths include a large, growing NICU population at two sites (Lucile Packard Children's Hospital and El Camino Hospital) with a total of 10,284 births, 1757 NICU admissions, and 94 beds with racial and ethnic diversity typical of the western US. In addition, a four-hospital network staffed by Stanford faculty and linked to the Johnson Center for Pregnancy and Newborn Services at Packard Children's Hospital ensures a robust referral population for clinical trials. PI, Krisa Van Meurs, and Alternate PI, David Stevenson, are skilled and experienced NRN investigators. Susan Hintz serves as Vice-Chair of follow-up, subcommittee member on seven trials, and has achieved an exceptional follow-up rate over 95%. Committed Stanford investigators originated, led, and/or analyzed five studies during last grant cycle (SUPPORT Neuroimaging study, SUPPORT School age follow-up, Preemie aEEG pilot, Predicting outcomes in HIE using aEEG, and Regional tissue oximetry in preterm infants during red blood cells transfusions). Valerie Chock received an Ancillary Studies in Clinical Trials R01 from NHLBI to fund the regional oximetry study. Stanford had extensive involvement in training with 15 visits to Network sites for aEEG training, and responsibility for SUPPORT NEURO School Age visit training in Scottsdale and Movement ABC gold standard training at Stanford. Faculty engagement is strong; 8 Stanford faculty have 28 subcommittee assignments. In addition, Stanford faculty neuroradiology collaborator Patrick Barnes was the central reader for SUPPORT MRI and Whole Body Hypothermia MRI studies, and Susan Hintz assisted in the development of NICHD MRI scoring system. Stanford faculty (Van Meurs, Wusthoff, Davis and Bonifacio) are central aEEG readers for three aEEG studies. Over the last 5 grant cycles Stanford has demonstrated wide- ranging expertise, exceptional leadership, and strong collaborative abilities that have served the NRN well. One of the greatest strengths Stanford has to offer is our extensive and talented pool of young clinical investigators that will become the clinical research leaders of the future. In summary, the Stanford site has the neonatal and subspecialty faculty, physical space, research resources, professional staff, institutional support and patient population necessary to continue as one of the finest centers participating in the NRN.